The other night I had my first code on my own. I had one patient. I'm not trying to be dramatic, but I had a feeling that something was going to happen that night. He was cruising along just fine. Pressures were fine, off pressors. Breathing was pretty good, satting 92-95% on 6L NC. Neutropenic guy. He was in pain on PCA Dilaudid, but said that his pain was the most tolerable that it had been in days...2-3/10 abdominal pain. He was fine. But for some reason I just had a feeling of impending doom.
Around 130a he started c/o SOB and that he felt he wasn't getting enough oxygen. To make a long story short, I called RT and the MD to the bedside, put on a SFM, then a 100% non-rebreather, then we tried him on Bipap b/c he has a hx of OSA. He was satting okay, but he was so cold and had poor peripheral perfusion, so getting an accurate reading was difficult. Then he started turning pale, perfusely diaphoretic, and had decreased mental status. It was decided then that we were going to intubate after his ABG came back with a pH of 6.998. The code was called and he was rapidly intubated. So when I left him he was on 4 pressors: Dopamine, Levophed, Neosynephrine, and Vasopressin. I literally was busy with that guy from 2am til I left giving fluids, titrating gtts, and drawing labs.
So yes. I survived my first code on my own!
